title: Severe rhabdomyolysis due to rosuvastatin in a liver transplant subject with human immunodeficiency virus and immunosuppressive therapy-related dyslipidemia.
abstract: Statins are relatively safe first-line agents to use in the setting of dyslipidemia associated with immunosuppressive therapy in subjects undergoing liver transplantation, and also in HIV-infected patients with dyslipidemia due to antiretroviral drugs, especially ritonavir-boosted protease inhibitors. Rosuvastatin, a new statin, has demonstrated higher potency than previously released statins and is not extensively metabolized by the liver P450 system; therefore, the probability of deleterious pharmacokinetic interactions with commonly used immunosuppressants and antiretroviral drugs is reduced. We present the first case of severe rhabdomyolysis in a liver transplant patient receiving rosuvastatin for the treatment of immunosuppressive therapy-related grade IV dyslipidemia, an HIV-infected subject on protease inhibitor-sparing HAART, that resolved after rosuvastatin withdrawal, probably related to interactions between calcineurin inhibitors and hepatic rosuvastatin uptake transporters such as organic anion transporting polypeptides (OATPs).
authors.affiliation: Infectious Diseases Service, Hospital Ramón y Cajal, Madrid, Spain. amoreno.hrc@salud.madrid.org
authors.forename: Ana
authors.initials: A
authors.lastname: Moreno
authors.forename: Jesús
authors.initials: J
authors.lastname: Fortún
authors.forename: Javier
authors.initials: J
authors.lastname: Graus
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Rodriguez-Gandía
authors.forename: Carmen
authors.initials: C
authors.lastname: Quereda
authors.forename: María J
authors.initials: MJ
authors.lastname: Pérez-Elías
authors.forename: Javier
authors.initials: J
authors.lastname: Nuño
authors.forename: Philip
authors.initials: P
authors.lastname: Wikman
authors.forename: Santiago
authors.initials: S
authors.lastname: Moreno
authors.forename: Rafael
authors.initials: R
authors.lastname: Bárcena
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D050171:Dyslipidemias / Q000139:chemically induced / Q000188:drug therapy*; D005464:Fluorobenzenes / Q000009:adverse effects*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016031:Liver Transplantation; D008297:Male; D011743:Pyrimidines / Q000009:adverse effects*; D012206:Rhabdomyolysis / Q000139:chemically induced* / Q000175:diagnosis; D000068718:Rosuvastatin Calcium; D012720:Severity of Illness Index; D013449:Sulfonamides / Q000009:adverse effects*
chemical_list: D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007166:Immunosuppressive Agents; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium